gum disease

The gums are part of the soft tissue lining of the mouth which is the tissue of the upper and lower jaws that surrounds the base of the teeth. Also called gingiva.

Gums are comprised of a soft skin which cover the bones of the mouth and part of tooth . Since the teeth and gums are so interconnected, gum problems can lead to teeth problems. On top of that, This tissue forms a tight seal around the teeth to hold the teeth firmly in place and provide a barrier against bacteria. Therefore if gum problems, which is called gingivitis, left untreated, gum disease could lead to bone and tooth loss.

 

What is Gum ?

The gum is the covering tissue on the jaw bone that holds the teeth firmly in place. Gum is made of skin, with the difference that it has one layer less. Unlike the skin, the gum does not have a stratum corneum. This is why the gum is naturally soft and sensitive.

The gum is made up of several layers of skin, each of which has a specific function

Under these layers, there is connective tissue that is full of collagen fibers. In addition to giving the gums a soft texture, these collagen fibers are a protective scaffold that protects the bone below from the bacteria of the mouth. The thicker this layer is, the more resistant the gum is and shows greater resistance to environmental impact. In the process of a connective tissue graft, surgeons technically remove this connective tissue and they stitch the tissue onto the existing gum tissue to increase its resistance.

These collagen fibers is full of connective tissue forming cells and defense cells and blood vessels that are responsible for feeding their upper layers.

 

What are gum problems?

In general, The gingival tissues (or gingiva, frequently called gums) are quite soft tissues. Whilst, The human being is constantly using his mouth for eating and talking, all of these  challenge the gum tissues. Although the gums usually cope with all these activities, there are still some common gum problems. what are the most important gum problems?

  • Gum Inflammation and Infection
  • Gum Abscess
  • Gum Recession
  • Autoimmune Disease 
  • Dark Gums 
  • Gingival Hyperplasia 
  • Bleeding Gums

 

Gum inflammation and infection

Infection means the invasion and growth of  germs into living tissue. The germs can be bacteria, viruses, yeast, fungi, or other microorganisms. Bacterial infection of the gums leads to inflammation which is in the early stages called Gingivitis when is just a gum inflammation. But it may spread to other parts of the periodontium where it becomes a more serious infection. The medical term for inflammation of the periodontium is periodontitis.

Gum inflammation and infection typically caused by poor oral hygiene meaning improper brushing and flossing habits that allow plaque—a sticky film of bacteria—to build up on the teeth and periodontium and harden. When these bacteria enter the gums, they cause inflammation and hyperemia (Gingival enlargement). Pain, hyperemia and infection of the gums are the results of bacterial invasion. But What is the best treatment for gum disease?

For the reason mentioned earlier, the fastest way to deal with gum inflammation and infection is proper brushing and flossing. Since bacteria who are growing in the gum convert sugar particles into acid, Not only does this give them the perfect place to grow, but it also offsets the pH of your mouth and supports plaque and calculus build-up. With the help of good oral hygiene, bacteria and food that feed them will be removed from the teeth and gums. As a result, your immune cells will spread into your gums to help destroy or kill bacteria that are causing the infection and help to fight with the infection.

This should also be considered that, those who have gum inflammation and infection usually suffer from excessive dental plaque. As  previously mentioned, this dental plaque is the place where bacteria accumulate. No matter how much you brush your teeth, plaques are still there. The only way to remove these tooth calculus or plaque is by teeth scaling. By removing scales and plaques from the teeth, the gums will heal quickly. That is why Scaling and Root Planing are necessary. 

If gingivitis left untreated, the gum will start to pull away from the tooth, the inflamed gum tissue is now the perfect environment for more bacteria and plaque to hide, deepening the pocket and threatening the health of the surrounding tissues of the tooth, which leads to bone loss. As mentioned earlier This stage of gum infection is called periodontitis.

 

Gum abscess

A gum abscess occurs when bad bacteria in the mouth grow in the space between the teeth and the gums causing an infection. Some gum abscesses result from periodontitis disease, and some are dental origin abscesses. Either way gum abscess are localized collection of pus in the alveolar bone at the root apex.

The dental origin gum abscess usually occurs following dental caries, trauma, deep fillings or failed root canal treatment. This condition can be painful. Bacteria leading to the Infection invade alveolar bone through tooth root canals and cause dental abscess or gum abscess.

Meanwhile, gum abscess which results from periodontitis disease is caused by either poor oral hygiene or sometimes sticking a foreign object in the gum, which involves the gum reaction.

Based upon the origin of gum abscess, the treatment is different:

  • treatment for dental origin abscess (dental abscess) is doing root canal for the damaged tooth or Apico procedure or tooth extraction and dental implant placement. 
  • treatment for gingival abscess with gingival origin is to drain away the pus from abscess, remove the foreign body and scale dental tartar and plaque and practice good oral hygiene.

 

Gum Recession

Diagnosing the root cause of gum recession is usually difficult and sometimes requires a specialist to analyze the case and figure out the cause of the problem. While,  gum recession treatment largely depends on what caused the condition, if the root cause is not identified and it is not fully corrected, any treatment is ineffective. But What is the main cause of receding gums?

Gum recession usually occurs in areas of the mouth where the connective tissue under the gums is thin. In addition,  excessive external pressure such as grinding teeth (bruxism) or brushing your teeth too hard and crooked teeth not only can wear away the enamel on your teeth but it also makes your gums recede. Depending on the causes, the treatment of receding gums is different:

  • Gum Graft: a gum graft thickens up the tissue, as the connective tissue becomes thicker, and as a result, it increases resistance of the gum against external forces to the gums.
  • Night Guard: Wearing a night guard on a regular basis, can minimize the destructive force of grinding of the teeth or bruxism, leading to reducing teeth damage. 
  • Orthodontics Treatments: with straightening crooked teeth, or treating an improper bite, boosting the long-term health of gums and teeth can be achieved.
  • Practice Good Oral Hygiene: For a healthier mouth, brush teeth thoroughly twice a day and floss daily between the teeth to remove dental plaque.

 

Dark Gum

The gum is made of several layers of skin, each of them has a specific function. The basal layer has cells called melanocytes which make melanin, which is a group of pigments in your gum that provides dark color.

Melanocytes reside in the basal layer of epidermis where they form the epidermal melanin units. An excess of melanin pigmentation in the skin is typically what causes black gums. Therefore It explains why People of African, Asian and Mediterranean ancestry and also who has a Wheatish complexion may have black gums or dark gums. 

To fix black gums, the best method is dental laser. With the help of soft tissue laser, the layer where the pigments reside in the gum is removed and the new gum is replaced. Unfortunately, this method is often temporary since within a year, the spots come back.

 

Autoimmune Diseases

Autoimmune disease is a condition in which your immune system mistakenly attacks your body. Autoimmune diseases are caused by the reaction of the body’s immune system against itself. Normally, the body’s immune system recognizes itself and does not react to the body itself. As a result of stress, the body’s immune system is triggered and mistakenly considers gum cells to be an antigen and attacks against it. The most common  autoimmune gum diseases are:

  • Aphthous Ulcers
  • Pemphigus Vulgaris
  • Pemphigoid
  • Leukoplakia
  • Lupus

All in all, treatment of autoimmune  diseases is using Immunosuppressant drugs like corticosteroids to weaken the body’s immune system,  leading to suppress this reaction. This helps reduce the impact of the autoimmune disease on the gum. In addition, Low-level laser therapy not only is considerably effective for the treatment of recurrent aphthous stomatitis but also in reducing pain associated with the disease.

 

Gingival Overgrowth (Hyperplasia)

In contrast to receding gums, in this case, we are facing with gingival overgrowth. This condition may be associated with hereditary factors or more commonly is a side-effect of certain drugs. 

Gingival enlargement can cause a cosmetic problem, furthermore interfere with eating and speech, make it difficult to practice an effective tooth cleaning and attribute to plaque accumulation.

In response to the question about what is the treatment for gingival overgrowth, it is worth mentioning that it depends on the cause.

If it’s a drug-induced gingival enlargement, the treatment is, in addition to appropriate plaque control, discontinuing or changing the inducing drug.

The treatment for the gingival hyperplasia associated with the patient’s genetic, is a surgical procedure which is called crown lengthening surgery to expose more of the tooth that is beneath the gum with the help of a dental laser.

 

Bleeding Gums

The first step to treat bleeding gums, is diagnosing the root cause of it.

The main reason for bleeding gums is inflammation and infection of the gums. This inflammation makes gum to become hyperemic and thin, and gums bleed when patients barely touch them. 

Bleeding gums are treated by removing dental calculus and plaque and improving oral health by Brushing regularly but not aggressively. However, if it still persists,  low-level laser therapy is very effective on bleeding gums. low-level laser shots can kill bacteria resides in  gums and can lead to provoke gums into healing process. 

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